INTRODUCTION

End-Stage Renal Disease (ESRD) was chosen to be presented. ESRD being the top 10
killer in the Philippines as of 2007 and is increasing that its morbidity and mortality rate is
predicted to double by year 2010, according to DOH.

As said in the news reports as of November 2008, that health experts raised an alarm over
the rising kidney diseases in the country, saying that more than 10,500 Filipinos are afflicted
with it. There are cases of children that account for 10 to 15 percent of the end-stage renal
disease (ESRD), primarily because of their lifestyle-diet that is high in salt or sugar and due to
lack of exercise. However, as cited in the Philippine Renal Registry of 2008, diabetes is a
primary cause of ESRD at 41 percent, followed by inflammation of kidney with 24 percent, and
high blood pressure at 22 percent. Today, diabetes mellitus and hypertension have been a central
cause in increasing the risk of ESRD which together account for almost 60% of dialysis patients.

End-Stage Renal Disease (ESRD) is a progressive, irreversible deterioration in renal

function in which the body’s maintenance of the metabolic, fluid and electrolyte balance fails,
resulting in uremia and azotemia; thus, it’s a condition where there is a complete or near-
complete failure of the kidney to perform its function to excrete waste and regulate electrolytes
and urine. It’s leading cause, diabetes mellitus or other systematic diseases such as, hypertension,
chronic glorerulonephritis, pyelonephritis, obstruction of the urinary tract, hereditary lesions as
in polycystic kidney disease, vascular disorders, infections, medications or toxic agents. The
comorbid conditions that develop during chronic renal insufficiency are the contributing factor to
the increase in morbidity and mortality of patients with ESRD. Environmental and occupational
agents such as cadmium, lead, mercury and chromium are said to implicate in the disease. The
symptoms that may result from the toxic build-up of waste products include a decrease in the
amount of urine, overall swelling of the body called edema, feeling out of breath or short of
breath, nausea and vomiting, poor appetite, metallic taste in the mouth, hiccups, weight loss or
weight gain with fluid, fatigue usually from anemia or low blood count, mental slowness or
confusion.

Dialysis and even kidney transplantation is necessary for the patient’s survival. It is used
to remove fluid and uremic waste products from the body when the kidneys are unable to. It may
also be used to treat patients with edema that doesn’t respond to other treatments, hepatic coma,
hyperkalemia, hypercalcemia, hypertension and uremia. Hemodialysis is the process of filtering
out toxins from the blood and returning the blood to the body. Peritoneal dialysis removes wastes
from the peritoneal cavity, which includes the belly and pelvic areas. The end-stage renal disease
treatment also includes a diet that restricts protein, potassium, and phosphorus, limited fluid
intake, control of blood pressure by antihypertensive drugs, and erythropoietin to improve
anemia.
 End-stage renal disease can sometimes be prevented by controlling high blood pressure
and managing diabetes very tightly. However, once ESRD occurs it is not reversible.